Nothing says “welcome to middle age” like age spots: They give your age away at first handshake and seem to multiply in record time. The skin-care aisle is full-to-bursting with creams and serums that promise to return your hands to their youthful glow, but most barely touch your ever-darkening spots. So we reached out to top dermatologists to, well, give us a hand.
Here are the three best dermatologist-recommended treatments to get rid of age spots, from super gentle to aggressive—but all are effective.
If you’re hoping for something that will make your hands look like you dipped them in the fountain of youth, you won’t find it in a cream or serum. No over-the-counter treatment will make your age spots disappear completely, according to Marina Peredo, MD, a board-certified dermatologist in Manhattan. But some creams will lighten spots.
Marguerite Germain, MD, a dermatologist in South Carolina, recommends SkinCeuticals Phyto+ ($80, skinceuticals.com). The serum is natural and gentle, according to Germain, and uses a blend of botanicals to reduce the appearance of dark spots. Cucumber and thyme extracts soothe and moisturize skin, while kojic acid (derived from fungi) and arbutin (an extract of the bearberry plant) simultaneously lighten and brighten.
Apply a small amount of the serum with your fingertips directly to the age spot. Since only a small amount is used and the serum absorbs quickly, it won’t rinse off every time you wash your hands like some age-spot creams. Just make sure that any unusual skin spots, like those that have a darker surrounding ring, are checked out by a derm for skin cancer before you try any lightening technique.
While they still won’t make every dark spot invisible, prescription treatments can lighten spots even better than over-the-counter medications. Both Peredo and Germain suggest Tri-Luma, a topical cream that lightens, exfoliates, and reduces inflammation in the skin on your hands and face ($109 to $118, triluma.com).
Tri-Luma is meant to be used for 8 weeks, but some people see improvement after only 4. In a study of patients using Tri-Luma to treat melasma, which causes brown spots on the face, 38% saw their spots disappear completely. Even in those patients, however, the spots often gradually return after treatment stops. When exposed to sunlight and UV light, the ingredients in Tri-Luma can make you more susceptible to sunburn and can cause dark patches of skin to get even darker, so don’t forget your sunscreen.
If you don’t think a cream is for you, or aren’t seeing the results you want, you might want to consider laser treatment. Dermatologists recommend PicoWay, which works on all skin tones of the face, chest, and hands—and can’t wash off like a cream. Instead of the photothermal waves (electromagnetic radiation in the form of infrared waves) used in older lasers, PicoWay uses ultra-short, picosecond (trillionths of a second) pulses to break down melanin pigment into tiny particles. The gentle pulses make PicoWay safer for all skin types.
“It’s almost like taking a sledgehammer to shatter pigment,” says Vic Narurkar, MD, a dermatologist and founder of the Bay Area Laser Institute. “Compared to previous lasers, fewer treatments are required, and often a single one is effective.” The pigment is then eliminated naturally by the body. With fewer treatments and less pain, “patients appreciate the minimal down time and the quickness of the procedure,” says Andrew Menkes, MD, a dermatologist and founder of the Menkes Clinic and Surgery Center of Mountain View, CA. It’s so painless, he doesn’t have to use a numbing agent before administering a treatment. Prices range from $450 to $750 per treatment.
Although lasers have become much safer over the years, they can carry the risk of post-inflammatory hyperpigmentation (PIH)—darkening or lightening of the skin, explains Narurkar. Any laser treatment can cause PIH, especially if you’re not careful about staying out of the sun or using sunscreen after treatment.
Photo by Getty Images/Jeffery Coolidge